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At the top left you can see the abdominal organs and the segmental vertebral levels where visceral sensory stimuli (pain) originate from that organ. At the top right is a dermatome card. Click the image to enlarge it. You can use these segmental representations and the dermatomes to answer the question below. Below, marked with letters A to D, are 4 patterns of pain that may occur. Red always indicates visceral pain (deep, in the middle line, not easily localizable, accompanied by autonomic symptoms), and purple 'referred pain' (occurring in dermatomes, often there is also hypersensitivity to light stimuli such as e.g. caressing the skin). Which pain pattern best describes acute cholecystitis?
The figure shows the pathways by which pain stimuli in the pelvic and perineum area run. You can use this when answering the next question. What kind of anesthesia during delivery can cause the mother to still feel the contractions, but not the pain of cervical dilatation and of stretching of the vagina and pelvic floor?
A 12 year old boy reports diffuse, poorly localizable, abdominal pain around the navel, such as the red area indicated in picture A. In addition, the area marked purple in picture A is painful to light touch. The GP considers an early acute appendicitis, but because the boy is only moderately ill, it is decided to adopt a conservative strategy. Two days later the boy comes for another consultation. On physical examination, unlike during the first consultation, the boy can now clearly indicate the location of the strongest pain, in the right lower abdomen, see the orange spot in image B. Of course, the general presentation, fever and lab are also considered, but what development of the disease process is likely, judging only from the development of the pain presentation?
What treatment (s) could provide palliative pain relief for uncontrollable pain associated with unresectable pancreatic cancer? Multiple answers are correct.
At the top left you can see the abdominal organs and the segmental vertebral levels where visceral sensory stimuli (pain) originate from that organ. At the top right is a dermatome card. Click the image to enlarge it. You can use these segmental representations and the dermatomes to answer the question below. Below, marked with letters A to D, are 4 patterns of pain that may occur. Red always indicates visceral pain (deep, in the middle line, not easily localizable, accompanied by autonomic symptoms), and purple 'referred pain' (occurring in dermatomes, often there is also hypersensitivity to light stimuli such as e.g. caressing the skin). Which pain pattern best describes kidney stones?
